滑动型食管裂孔疝引起的复发性急性心力衰竭。
Recurrent acute heart failure caused by sliding hiatus hernia.
作者信息
Siu C-W, Jim M-H, Ho H-H, Chu F, Chan H-W, Lau C-P, Tse H-F
机构信息
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
出版信息
Postgrad Med J. 2005 Apr;81(954):268-9. doi: 10.1136/pgmj.2004.023416.
The case is reported of a 75 year old woman who presented with recurrent nocturnal episodes of acute pulmonary oedema. The cause was uncertain as she had normal cardiothoracic ratio on chest radiography and normal left ventricular systolic and diastolic function by transthoracic echocardiogram. Another transthoracic echocardiogram was repeated when she was recumbent for an hour and had a full stomach. It showed a striking finding of severe left atrial compression by an external structure. Computed tomography of the thorax showed an intrathoracic mass behind the left atrium causing external compression of the left atrium suggestive of a sliding hiatus hernia. Cardiac catheterisation confirmed the diagnosis by showing a pronounced rise of pulmonary capillary wedge pressure in the recumbent position compared with the sitting up position.
报道了一例75岁女性，她反复出现夜间急性肺水肿发作。病因不明，因为她胸部X线片显示心胸比例正常，经胸超声心动图显示左心室收缩和舒张功能正常。当她仰卧一小时且饱腹时再次进行经胸超声心动图检查。结果显示一个显著发现，即外部结构严重压迫左心房。胸部计算机断层扫描显示左心房后方有一胸腔内肿块，对左心房造成外部压迫，提示滑动型食管裂孔疝。心导管检查通过显示仰卧位与坐位相比肺毛细血管楔压明显升高来确诊。
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